CHEST Guidelines-Causes-of-Poor-Medication-Adherence-in-Sarcoidosis

Causes-of-Poor-Medication-Adherence-in-Sarcoidosis

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Medication nonadherence is a significant issue in managing sarcoidosis, with reports indicating 66% of patients at a university clinic not adhering to their medication regimen. This suggests flaws in current treatment approaches that need addressing. Adherence refers to how well patients follow prescribed treatments, and it is typically higher for acute conditions than chronic ones. Causes of nonadherence include cognitive impairment, forgetfulness, psychosocial factors, the chronic nature of the disease, side effects, complex regimens, and poor communication between clinicians and patients. Effective communication is crucial for adherence, as it enables clear explanation of treatments, discussion of side effects, and patient concerns.<br /><br />Corticosteroids, commonly used in sarcoidosis, often cause significant side effects leading to nonadherence. Their side effects, coupled with the fact that they do not cure sarcoidosis but may worsen long-term quality of life, contribute to this issue. Studies reveal nonadherence in corticosteroid use due to adverse reactions, dissatisfaction with doctor-patient relationships, and perceptions of drug inefficacy. Sarcoidosis patients, facing chronic conditions requiring prolonged therapy, often find themselves trading sarcoidosis symptoms for corticosteroid side effects without a cure.<br /><br />Communication issues and unsuitable treatment regimens are central to nonadherence, highlighting the need for a reevaluation of corticosteroid use in favor of alternative regimens. African American patients were found to adhere less than white patients in Sharp’s study, differing from previous research. Addressing these adherence concerns involves forming better patient-clinician relationships and aligning treatment plans with patient preferences. The high rate of nonadherence calls for improved communication and considering new therapies beyond corticosteroids to enhance patients' quality of life.

Keywords

medication nonadherence

sarcoidosis

treatment approaches

corticosteroids

side effects

chronic conditions

patient-clinician communication

alternative regimens

quality of life

African American patients